急性心肌炎老年与非老年患者临床特点比较
摘要
目的探讨急性心肌炎老年与非老年患者的临床特点、治疗及预后。方法回顾性分析急性心肌炎患者133例,按年龄分两组,其中年龄≥60周岁的患者22例为老年组,其余纳入非老年组。比较两组的临床特点、实验室检查结果、治疗方式、转归及住院期间主要心脏不良事件(MACE,包括室颤、心源性休克和死亡)的发生率。结果与非老年组相比,老年组起病隐匿,从前驱期症状出现到明显心功能不全的潜伏期明显延长(P<0.05)。住院期间MACE在老年组出现6例(27.3%),非老年组10例(9.0%),两组相比差异具有统计学意义(P=0.022);生命支持治疗在老年组应用比例更高(P<0.05)。结论老年急性心肌炎患者临床并不少见,多数起病隐匿、潜伏期长,临床表现不典型,住院期间MACE发生率高,病情重且死亡率高,需要及时采取生命支持治疗。
引文
1 郭晓辰,张军平,朱亚萍.病毒性心肌炎患者生活质量量表的信度与效度研究[J].中华中医药杂志,2012;27(4):857-61.
2 Jeserich M,Olschewski M,Kimmel S,et al.Acute results and long-term follow-up of patients with accompanying myocarditis after viral respiratory or gastrointestinal tract infection[J].Int J Cardiol,2014;174(3):853-5.
3 《中华心血管病杂志》编辑委员会心肌炎心肌病对策专题组.关于成人急性病毒性心肌炎诊断参考标准和采纳世界卫生组织及国际心脏病学会联合会工作组关于心肌病定义和分类的意见[J].中国循环杂志,2001;16(4):307-8.
4 Gross UM,Noutsias M,Lassner D,et al.Prevalence of erythrovirus genotypes in the myocardium of patients with dilated cardiomyopathy[J].J Med Virol,2008;80(7):1243-51.
5 胡伟航,刘长文,胡炜,等.体外膜肺氧合治疗暴发性心肌炎患者的临床研究[J].中华危重症医学杂志(电子版),2016;9(6):371-5.
6 中华医学会心血管病分会精准医学学组.成人暴发性心肌炎中国专家共识[J].中华心血管病杂志,2017;45(9):742-52.
7 Olimulder MAGM,van Es J,Galjee MA.The importance of cardiac MRI as a diagnostic tool in viral myocarditis-induced cardiomyopathy[J].Neth Heart J,2009;17(12):481-6.
8 Gupalo EM,Mironova NA,Stukalova OV,et al.A case of arrhythmia due to myocarditis treated by antiviral therapy:new diagnostic approaches using peripheral biomarkers[J].Eur Heart J,2013;34(suppl 1):17.
9 Kühl U,Schultheiss HP.Viral myocarditis:diagnosis,aetiology and management[J].Drugs,2009;69(10):1287.
10 Mirabel M,Leger P,Combes A,et al.Outcomes,long-term quality of life,and psychologic assessment of fulminant myocarditis patients rescued by mechanical circulatory support[J].Crit Care Med,2011;39(5):1029-35.
2 Jeserich M,Olschewski M,Kimmel S,et al.Acute results and long-term follow-up of patients with accompanying myocarditis after viral respiratory or gastrointestinal tract infection[J].Int J Cardiol,2014;174(3):853-5.
3 《中华心血管病杂志》编辑委员会心肌炎心肌病对策专题组.关于成人急性病毒性心肌炎诊断参考标准和采纳世界卫生组织及国际心脏病学会联合会工作组关于心肌病定义和分类的意见[J].中国循环杂志,2001;16(4):307-8.
4 Gross UM,Noutsias M,Lassner D,et al.Prevalence of erythrovirus genotypes in the myocardium of patients with dilated cardiomyopathy[J].J Med Virol,2008;80(7):1243-51.
5 胡伟航,刘长文,胡炜,等.体外膜肺氧合治疗暴发性心肌炎患者的临床研究[J].中华危重症医学杂志(电子版),2016;9(6):371-5.
6 中华医学会心血管病分会精准医学学组.成人暴发性心肌炎中国专家共识[J].中华心血管病杂志,2017;45(9):742-52.
7 Olimulder MAGM,van Es J,Galjee MA.The importance of cardiac MRI as a diagnostic tool in viral myocarditis-induced cardiomyopathy[J].Neth Heart J,2009;17(12):481-6.
8 Gupalo EM,Mironova NA,Stukalova OV,et al.A case of arrhythmia due to myocarditis treated by antiviral therapy:new diagnostic approaches using peripheral biomarkers[J].Eur Heart J,2013;34(suppl 1):17.
9 Kühl U,Schultheiss HP.Viral myocarditis:diagnosis,aetiology and management[J].Drugs,2009;69(10):1287.
10 Mirabel M,Leger P,Combes A,et al.Outcomes,long-term quality of life,and psychologic assessment of fulminant myocarditis patients rescued by mechanical circulatory support[J].Crit Care Med,2011;39(5):1029-35.